Clinical Endoscopy

  • 제42권6호
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  • Pages.373-377
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  • 2011
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  • 2234-2400(pISSN)
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  • 2234-2443(eISSN)
대한소화기내시경학회 (The Korean Society of Gastrointestinal Endoscopy)
권호 표지

위문 폐색 증상을 보인 이소성 췌장의 악성변화에 의해 발생한 위암

A Case of Gastric Adenocarcinoma Arising from Ectopic Pancreas showing Gastric Outlet Obstruction

  • 정석현 (한양대학교 의과대학 내과학교실) ;
  • 이항락 (한양대학교 의과대학 내과학교실) ;
  • 백승삼 (한양대학교 의과대학 병리학교실) ;
  • 한호림 (한양대학교 의과대학 병리학교실) ;
  • 하태경 (한양대학교 의과대학 외과학교실) ;
  • 박병배 (한양대학교 의과대학 내과학교실) ;
  • 최창렬 (한양대학교 의과대학 내과학교실) ;
  • 송순영 (한양대학교 의과대학 영상의학교실)
  • Jung, Suk-Hyun (Department of Internal Medicine, Hanyang University College of Medicine) ;
  • Lee, Hang-Lak (Department of Internal Medicine, Hanyang University College of Medicine) ;
  • Paik, Seung-Sam (Department of Pathology, Hanyang University College of Medicine) ;
  • Han, Hu-Lin (Department of Pathology, Hanyang University College of Medicine) ;
  • Ha, Tae-Kyung (Department of Surgery, Hanyang University College of Medicine) ;
  • Park, Byeong-Bae (Department of Internal Medicine, Hanyang University College of Medicine) ;
  • Choi, Chang-Ryeol (Department of Internal Medicine, Hanyang University College of Medicine) ;
  • Song, Soon-Young (Department of Radiology, Hanyang University College of Medicine)
  • 발행 : 2011.06.30
⟨ 이전 논문 다음 논문 ⟩

초록

소화기관 내의 이소성 췌장은 대부분 우연히 발견되며 악성변화는 극히 드물다. 저자들은 위문 폐색 증상을 보인 이소성 췌장의 악성 변화에 의해 발생한 위암 1예를 경험하였기에 보고한다. 69세 여자가 구토를 주소로 본원으로 내원하였다. 위내시경에서 유문앞 전정부를 둘러싸는 형태의 점막하 병변으로 인한 배출구 폐색이 보였다. 복부 컴퓨터단층촬영에서 유문부를 둘러싸는 종양과 양성자방출 단층 촬영에서 과대사를 보이는 벽 비후가 관찰되어 위부분절제술을 시행하였다. 수술 후 병리 조직에서 중등도 분화된 선암종이 보였고 종양 세포는 cytokeratin 7에 강하게 염색되었다. 종양은 이소성 췌장 조직에 밀접해 있었다. 종양은 장막 하와 그물막을 침범하였다. 1개의 림프절에 전이가 되었으며 원격 전이는 없었다. 환자는 현재 외래 추적 관찰 중이다.

An ectopic pancreas in the gastrointestinal tract is mostly found incidentally and its malignant transformation is extremely rare. We report herein a rare case of malignant transformation of ectopic pancreas in the stomach, associated with gastric outlet obstruction. A 69-year-old woman was admitted to our hospital, complaining of vomiting. Esophagogastroduodenoscopy revealed an encircling submucosal tumor-like lesion on the prepyloric antrum showing outlet obstruction. Abdominal CT showed an enhancing mass on the antrum and PET CT showed hypermetabolic wall thickening. So we performed a subtotal gastrectomy. Surgical specimens showed a moderately differentiated ductal adenocarcinoma, and the tumor cells were strongly positive for cytokeratin 7. The tumor was located close to the ectopic pancreas tissue. The tumor showed subserosal and omental invasion. There was one lymph node metastasis and no distant metastasis. The patient is being followed up in the outpatient department.

키워드

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